Fibromyalgia—an unsolved mystery—is a complex syndrome with no known cause or sure cure. According to research or other evidence, the following self-care steps may be helpful.
Low-intensity exercise (like walking or swimming) is the best known treatment
Address your stress
Reducing stress and unpleasant emotions may also reduce symptoms
100 mg of the supplement 5-hydroxytryptophan three times a day may ease symptoms
Check out SAMe
800 mg of the supplement S-adenosyl-l-methionine a day may help symptoms
About This Condition
Fibromyalgia is a complex syndrome with no known cause or cure. Its predominant symptom is pain in the
fibrous tissues, muscles, tendons, and ligaments, although other symptoms may be experienced.
Research has demonstrated that the axis connecting the three glands primarily responsible for the stress
response (hypothalamus, pituitary, adrenals) may be dysfunctional in people with fibromyalgia.1 Inflammation of the involved
structures is generally absent in fibromyalgia.
Of the estimated three to six million people2 affected by this disorder in the United States, the
vast majority are women between 25 and 45 years of age.
Trigger-point pain at characteristic locations is the defining symptom of fibromyalgia. The most commonly affected locations are on the occiput (nape of the neck), the neck itself, shoulders, trunk, low back, and thighs. Other symptoms may also be experienced, including fatigue, chest pain, low-grade fever, swollen lymph nodes, insomnia, frequent abdominal pain, irritable bowel syndrome, and depression.3
Healthy Lifestyle Tips
Low-intensity exercise may improve fibromyalgia symptoms. People with fibromyalgia who exercise regularly have been reported to suffer less severe symptoms than those who remain sedentary.4, 5, 6 In a controlled trial, a program consisting of two 25-minute exercise classes plus two educational sessions per week for six weeks resulted in immediate and sustained improvement in walking distance, fatigue, and well-being in a group of people with fibromyalgia;7 however, no reductions in pain, anxiety, or depression were seen. In a more recent controlled trial, a 35-minute exercise program in a warm pool once a week for six months, coupled with counseling sessions, led to improvements in hand-grip strength and endurance, as well as to reductions in pain, distress, depression, and anxiety.8 The results of this trial, and other similar trials, suggest that underwater exercise training, in combination with a counseling intervention, should be considered by people with fibromyalgia.
Stress is believed by some researchers to be capable of aggravating fibromyalgia symptoms. Stress-reduction techniques, such as meditation, have proven helpful in preliminary research.9
Acupuncture may be useful for short-term relief of fibromyalgia symptoms. In one preliminary trial, acupuncture produced a significant decrease in pain and point tenderness along with related biochemical changes measured in the fibromyalgia patients’ blood.10 Another uncontrolled trial used electroacupuncture (acupuncture with electrical stimulation) treatment in people with fibromyalgia who were unresponsive to conventional medical therapies. After an average of seven treatments per person, 46% claimed that electroacupuncture provided the best relief of symptoms when compared to all other therapies, and 64% reported using less medication for pain relief than prior to electroacupuncture.11 A double-blind trial compared fake acupuncture to electroacupuncture and reported significant differences in improvement in five of eight outcome measurements among people with fibromyalgia.12 Short-term pain reduction in people with fibromyalgia has been reported in other studies, some of which were at least partially controlled; however, long-term benefits have never been investigated in a controlled clinical trial.13 Long-term controlled trials are necessary to conclusively determine whether acupuncture is a useful treatment for fibromyalgia.
Joint manipulation, chiropractic, and related treatments may be helpful for relieving some of the symptoms of fibromyalgia. A preliminary study14 found that almost half of people with fibromyalgia who received chiropractic care had “moderate to good” improvement. A small preliminary trial15 evaluated the effect of four weeks of chiropractic treatment (three to five times per week) consisting of soft tissue massage, stretching, spinal manipulation, and general advice and information. Treatment resulted in a significant decrease in pain and an increase in range of neck movement, but there was no improvement in tender points or in ability to function in daily life. Another preliminary trial16 evaluated a longer treatment period (30 sessions) consisting of spinal manipulation and deep pressure massage to tender points in the muscles. More benefit was reported by this study, as 60% of the patients experienced significant pain reduction, reduced sensed of fatigue, and improved sleep. These benefits persisted one month after the treatment was completed. People who did not feel better after 15 treatments were not likely to benefit from this type of treatment. No controlled research has evaluated manipulation therapies for fibromyalgia.
The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.
Try a vegan diet
A vegan diet (includes no animal products) that is also low in salt may help women with fibromyalgia.
A vegan diet (includes no animal products) that is also low in salt may help women with fibromyalgia. In a controlled clinical trial,17 women with fibromyalgia were put on a special diet consisting only of raw foods—primarily fruits, vegetables, nuts, seeds, legumes, and cereals (such as rolled oats). The diet also contained several fermented foods, including a fermented yogurt-food made from oats, a fermented beverage made from wheat berries (called Rejuvalac), and several types of fermented vegetables, particularly cabbage. During the three-month trial, women following the therapeutic diet experienced a significant reduction in body weight, pain, morning sickness, use of painkillers, depression, and the number of sore fibromyalgia points, compared with those who continued to eat their regular diet. Due to the liberal use of nuts and seeds, this diet was not low in fat; for example, 31% of all calories came from fat. Nonetheless, the total number of calories was relatively low (less than 1,900 calories per day), which was probably responsible for the decrease in body weight.
Cut out MSG
In one report, women with fibromyalgia experienced improvement or complete resolution of their symptoms after eliminating MSG or MSG plus aspartame from their diet.
In a preliminary report, four women with fibromyalgia experienced marked improvement or complete resolution of their symptoms within months after eliminating monosodium glutamate (MSG) or MSG plus aspartame from their diet. In each case, symptoms recurred whenever MSG was ingested.18
Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 StarsReliable and relatively consistent scientific data showing a substantial health benefit.
2 StarsContradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 StarFor an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
100 mg three times per day
People with fibromyalgia often have low serotonin levels in their blood.19, 20, 21 Supplementation with 5-HTP may increase serotonin synthesis in these cases. Both preliminary22, 23 and double-blind trials24 have reported that 5-HTP supplementation (100 mg three times per day) relieves some symptoms of fibromyalgia.
1,500 mg daily for ten weeks
In a double-blind trial, supplementation with acetyl-L-carnitine in the amount of 1,500 mg per day for ten weeks was significantly more effective than a placebo in improving musculoskeletal pain, depression, and general health in people with fibromyalgia.25
800 mg daily
Intravenous SAMe (S-adenosylmethionine) given to people with fibromyalgia reduced pain and depression in two double-blind trials;26, 27 but no benefit was seen in a short (ten-day) trial.28 Oral SAMe (800 mg per day for six weeks) was tested in one double-blind trial and significant beneficial effects were seen, such as reduced pain, fatigue, and stiffness, and improved mood.29
Refer to label instructions
In a preliminary trial, supplementing with coenzyme Q10 (100 mg three times per day for three months) resulted in significant improvements in headaches and overall symptoms in patients with fibromyalgia.30 In another study, cellular levels of CoQ10 were significantly lower in women with fibromyalgia than in healthy women. In the same study, ten women with fibromyalgia received 300 mg of CoQ10 per day for three months. Significant improvements were seen in symptoms such as fatigue, pain, depression, and anxiety.31 Placebo-controlled trials are needed to confirm these preliminary observations.
Refer to label instructions
A preliminary trial found that a combination of magnesium and malic acid might lessen muscle pain in people with fibromyalgia.32 The amounts used in this trial were 300–600 mg of elemental magnesium and 1,200–2,400 mg of malic acid per day, taken for eight weeks. A double-blind trial by the same research group using 300 mg magnesium and 1,200 mg malic acid per day found no reduction in symptoms, however.33 Though these researchers claimed that magnesium and malic acid appeared to have some effect at higher levels (up to 600 mg magnesium and 2,400 mg malic acid), the positive effects were not demonstrated under blinded study conditions. Therefore, the evidence supporting the use of these supplements for people with fibromyalgia remains weak and inconclusive.
Refer to label instructions
A preliminary trial found that a combination of magnesium and malic acid might lessen muscle pain in people with fibromyalgia.34 The amounts used in this trial were 300–600 mg of elemental magnesium and 1,200–2,400 mg of malic acid per day, taken for eight weeks. A double-blind trial by the same research group using 300 mg magnesium and 1,200 mg malic acid per day found no reduction in symptoms, however.35 Though these researchers claimed that magnesium and malic acid appeared to have some effect at higher levels (up to 600 mg magnesium and 2,400 mg malic acid), the positive effects were not demonstrated under blinded study conditions. Therefore, the evidence supporting the use of these supplements for people with fibromyalgia remains weak and inconclusive.
Refer to label instructions
Melatonin supplementation may be useful in the treatment of fibromyalgia. In a preliminary trial, 3 mg of melatonin at bedtime was found to reduce tender points and to improve sleep and other measures of disease severity, though pain and fatigue improved only slightly.36
80 mg anthocyanins, the equivalent of approximately 100–120 cherries, 16–24 ounces tart cherry juice blend, 1 ounce of liquid concentrate, or 400 mg of concentrate in tablets or capsules
Tart cherries contain antioxidants and anti-inflammatory substances that may reduce muscle pain,37, 38 and double-blind research in athletes has shown pain-reducing properties of tart cherry preparations.39, 40 In a small double-blind study, women with fibromyalgia drank 10.5 ounces twice daily of either tart cherry juice (equivalent to 100 to 120 cherries or 80 mg of anthocyanins per day) or a placebo juice for ten days prior to performing a session of intense elbow flexion exercise. While about one-third of the women reported significantly less elbow muscle pain when using tart cherry juice before exercise, the average effect in the overall group was no better than with the placebo.41
Refer to label instructions
Some studies have found low vitamin B1 (thiamine) levels and reduced activity of some thiamine-dependent enzymes among people with fibromyalgia.42, 43 The clinical significance of these findings remains unknown.
Refer to label instructions
One early preliminary study described the use of vitamin E supplements in the treatment of “fibrositis”—the rough equivalent of what is today called fibromyalgia. Several dozen individuals were treated with vitamin E using amounts ranging from 100–300 IU per day. The results were positive and sometimes dramatic.44 Double-blind trials are needed to confirm these preliminary observations.
Find Drug Interaction Information
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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2014.
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